Poor clearance of minimal residual disease (MRD) before allogeneic hematopoietic stem cell transplantation (HSCT) is an independent prognostic risk factor for reduced survival in patients who have myelodysplastic syndromes (MDS) with excess blasts.
Ying-Ying Ma, of the Army Medical University in Chongqing, China, and colleagues conducted the study and published their findings in Cancer.
They retrospectively analyzed the relationship between pretransplant MRD status and long-term survival in patients who had MDS with excess blasts and underwent allogeneic HSCT between March 2005 and November 2020. They used univariate and multivariate logistic regression models to analyze the relationship between pretransplant MRD status and long-term survival.
The study included 198 patients, 103 of whom underwent MRD testing before transplantation. Of those 103 patients, 67 were MRD positive, and 36 were MRD negative. The median patient age was 41 years and 58% of patients were men. The median follow-up was 16 months.
The complete remission rate was 61.1% for all patients. The three-year disease-free survival probability for all patients was 70.1%, while the three-year overall survival (OS) probability was 72.9%. In the patients who were in complete remission, the three-year disease-free survival probability was 72.2%, while the three-year OS probability was 74.8%.
The three-year disease-free survival rate for patients who were MRD negative was 85.6%, while it was 66.5% for those who were MRD positive (P=.045). The three-year OS rate was 91.3% for patients who were MRD negative, while it was 66.4% for those who were MRD positive (P=.035).
Poor MRD clearance before allogeneic HSCT was an independent prognostic risk factor for disease-free survival and OS in univariate and multivariate analysis, according to the study’s authors.
“Poor pretransplantation MRD clearance is an independent prognostic risk factor for long-term survival after [allogeneic] HSCT for patients with MDS [with excess blasts],” the study’s authors concluded.
Ma YY, Wei ZL, Xu YJ, et al. Poor pretransplantation minimal residual disease clearance as an independent prognostic risk factor for survival in myelodysplastic syndrome with excess blasts: a multicenter, retrospective cohort study. Cancer. 2023. doi:10.1002/cncr.34762